Recent Advances in Pulmonary Rehabilitation for Patients in the Intensive Care Unit (ICU)

• 佐藤, 隆平

  Department of Critical Care Nursing, School of Human Health Science, Kyoto University Graduate School of Medicine

• Ebihara, Satoru

  Department of Rehabilitation Medicine, Toho University Graduate School of Medicine

• Kohzuki, Masahiro

  Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine

抄録

Pulmonary rehabilitation is important to prevent complications in critically ill patients in the intensive care unit (ICU) who are on mechanical ventilation. However, the effectiveness and adverse events related to pulmonary rehabilitation for patients in the ICU are largely unclear because of the diversity of diseases and various levels of severity in this situation. This review aims to clarify the evidence currently available for pulmonary rehabilitation in critically ill adult patients requiring mechanical ventilation, with a focus on positioning and early mobilization. Prone positioning (PP) does not seem to benefit adults with hypoxemia mechanically ventilated in the ICU. However, it improved survival among patient subgroups like those enrolled within 48 h of meeting the trial entry criteria, those treated with PP for ≥16 h per day, and those with severe hypoxemia at trial entry. PP using the protective lung ventilation strategy for patients with acute respiratory distress syndrome was associated with reduced mortality. On the other hand, PP may cause pressure sores and tracheal tube obstruction. The semi-recumbent position may prevent ventilator-associated pneumonia with no adverse events. Early mobilization (EM) enhances mobility status and muscle strength and increases days of life and out of the hospital for up to 6 months; it also shortens the duration of delirium. The main adverse events with EM are hemodynamic changes and desaturation. Therefore, medical staff should carry out pulmonary rehabilitation for patients in the ICU, given the effectiveness and adverse events. Future studies should identify diseases that would benefit from pulmonary rehabilitation and optimize the method.

収録刊行物

• Pulmonary Research and Respiratory Medicine – Open Journal (PRRMOJ)

  Pulmonary Research and Respiratory Medicine – Open Journal (PRRMOJ) Special Edition (2), S51-S54, 2017-06-21

  Openventio

キーワード

• Pulmonary rehabilitation
• Intensive care unit (ICU)
• Positioning
• Early mobilization

詳細情報

• CRID: 1050564285802687872
• NII論文ID: 120006318848
• ISSN: 23771658
• HANDLE: 2433/226273
• 本文言語コード: en
• 資料種別: journal article
• データソース種別:
  • IRDB
  • CiNii Articles